Federal Register/Vol. 85, No. 90/Friday, May 8, 2020/Rules And
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27550 Federal Register / Vol. 85, No. 90 / Friday, May 8, 2020 / Rules and Regulations DEPARTMENT OF HEALTH AND health clinics, hospitals, critical access CMHCs to furnish outpatient services at HUMAN SERVICES hospitals (CAHs), community mental temporary expansion sites, including health centers (CMHCs), clinical the beneficiary’s home and expanded Centers for Medicare & Medicaid laboratories, teaching hospitals, CMHCs; expansion of the extraordinary Services providers of the laboratory testing circumstances relocation exception benefit in Medicaid, Opioid treatment policy for on-campus and excepted off- 42 CFR Parts 409, 410, 412, 413, 414, programs, and quality reporting campus provider-based departments 415, 424, 425, 440, 483, 484, and 600 programs (QRPs) for inpatient (PBDs) that relocate in response to the rehabilitation facilities (IRFs), long-term COVID–19 PHE; teaching physician Office of the Secretary care hospitals (LTCHs), skilled nursing policies, including time spent by facilities (SNFs), home health agencies residents at another hospital and the 45 CFR Part 156 (HHAs) and durable medical equipment, medical education methodology of [CMS–5531–IFC] prosthetics, orthotics, and supplies counting teaching hospital beds; (DMEPOS) suppliers. counting beds for provider-based rural RIN 0938–AU32 DATES: health clinic payment level; services Effective date: These regulations are furnished by opioid treatment programs; Medicare and Medicaid Programs, effective on May 8, 2020. modified requirements for ordering Basic Health Program, and Exchanges; Applicability date: The policies in COVID–19 diagnostic laboratory tests; Additional Policy and Regulatory this IFC are applicable beginning on payment to hospitals and physician’s Revisions in Response to the COVID– March 1, 2020, or January 27, 2020, offices for specimen collection; counting 19 Public Health Emergency and Delay except as further described in the table time for telehealth evaluation and of Certain Reporting Requirements for in SUPPLEMENTARY INFORMATION. management visits; method for updating the Skilled Nursing Facility Quality Comment date: To be assured the telehealth list during the PHE; Reporting Program consideration, comments must be paying for remote monitoring services; AGENCY: Centers for Medicare & received at one of the addresses and increased payment for telephone Medicaid Services (CMS), HHS. provided below, no later than 5 p.m. on evaluation and management visits (Note this email address has an underscore‘‘_ ACTION: Interim final rule with comment July 7, 2020. ’’ between ‘‘HAPG’’ and ‘‘COVID–19’’.) period. ADDRESSES: In commenting, please refer to file code CMS–5531–IFC. [email protected], for issues SUMMARY: This interim final rule with Comments, including mass comment related to the Medicare IRF benefits. comment period (IFC) gives individuals submissions, must be submitted in one [email protected], for issues and entities that provide services to of the following three ways (please related to section 3712 of the CARES Medicare, Medicaid, Basic Health choose only one of the ways listed): Act. Program, and Exchange beneficiaries 1. Electronically. You may submit Hillary Loeffler, (410) 786–0456, needed flexibilities to respond electronic comments on this regulation [email protected], or effectively to the serious public health to http://www.regulations.gov. Follow [email protected], for issues threats posed by the spread of the the ‘‘Submit a comment’’ instructions. related to the Medicare home health and coronavirus disease 2019 (COVID–19). 2. By regular mail. You may mail hospice benefits. Recognizing the critical importance of written comments to the following [email protected], for expanding COVID–19 testing, we are address ONLY: Centers for Medicare & issues related to the Partial amending several Medicare policies on Medicaid Services, Department of Hospitalization Program (PHP) and an interim basis to cover FDA- Health and Human Services, Attention: CMHC issues. authorized COVID–19 serology tests, to CMS–5531–IFC, P.O. Box 8016, MedicaidHomeHealthRule@ allow any healthcare professional Baltimore, MD 21244–8016. cms.hhs.gov, for issues pertaining to the authorized to do so under State law to Please allow sufficient time for mailed Medicaid home health benefit related to order COVID–19 diagnostic laboratory comments to be received before the section 3708 of the CARES Act. tests (including serological and antibody close of the comment period. Kari Vandegrift, (410) 786–4008, and tests), and to provide for new specimen 3. By express or overnight mail. You Elizabeth November, (410) 786–4518 or collection fees for COVID–19 testing may send written comments to the [email protected], under the Physician Fee Schedule and following address ONLY: Centers for for issues related to the Medicare Outpatient Prospective Payment Medicare & Medicaid Services, Shared Savings Program. System, during the public health Department of Health and Human Leigha Basini, (301) 492–4380, for emergency (PHE) for the COVID–19 Services, Attention: CMS–5531–IFC, issues related to the separate billing pandemic. Recognizing the urgency of Mail Stop C4–26–05, 7500 Security requirement. this situation, and understanding that Boulevard, Baltimore, MD 21244–1850. Sheri Gaskins, (410) 786–9274, for some pre-existing CMS rules may For information on viewing public issues related to Medicaid laboratory inhibit innovative uses of technology comments, see the beginning of the flexibilities. and capacity that might otherwise be SUPPLEMENTARY INFORMATION section. Cassandra Lagorio, (410) 786–4554, effective in the efforts to mitigate the FOR FURTHER INFORMATION CONTACT: for issues related to the BHP. impact of the pandemic on beneficiaries Rebecca Cole, (410) 786–1589, for Molly MacHarris, (410) 786–4461, or and the American public, we are general information, or contact one of [email protected], for issues related to amending several CMS policies and the following: the Merit-based Incentive Payment regulations in response to the COVID– [email protected], for System (MIPS). 19 PHE and recent legislation, as issues related to the HHVBP Model. NCDsPublicHealthEmergency@ outlined in this IFC. These changes [email protected], for cms.hhs.gov, for issues related to apply to physicians and other issues related to scope of practice national coverage determination and practitioners, hospice providers, issues; additional flexibilities for local coverage determination federally qualified health centers, rural hospital outpatient departments and requirements. VerDate Sep<11>2014 18:51 May 07, 2020 Jkt 250001 PO 00000 Frm 00002 Fmt 4701 Sfmt 4700 E:\FR\FM\08MYR2.SGM 08MYR2 Federal Register / Vol. 85, No. 90 / Friday, May 8, 2020 / Rules and Regulations 27551 Joan Proctor, (410) 786–0949, or Julia Venanzi, (410) 786–1471, for SUPPLEMENTARY INFORMATION: The [email protected], for issues related to the Hospital VBP policies in this IFC are applicable issues related to the following Post- Program. beginning on March 1, 2020, or January Acute Care QRPs: HH QRP, IRF QRP, Adam Rubin, (410–786–1919), for 27, 2020, except as further described in LTCH QRP, and SNF QRP. issues related to Certification of Home the following table: Health Services. Provision Applicability date Medicare Shared Savings Program—Expansion We are revising § 425.400 to expand the definition of primary care services used in the Shared of Codes used in Beneficiary Assignment. Savings Program beneficiary assignment methodology for the performance year starting on January 1, 2020, and for any subsequent performance year that starts during the PHE for the COVID–19 pandemic, as defined in § 400.200, which includes any subsequent renewals. Modification to Medicare Rules and Medicaid We are revising §§ 409.41 through 409.48; 424.22; 424.507(b)(1); § 440.70(a)(2) and (3), and Concerning Certification and Provision of (b)(1), (2) and (4); and several sections of 42 CFR part 484 to include physician assistants, Home Health Services. nurse practitioners, and clinical nurse specialists as individuals who can certify the need for home health services and order services. These changes are permanent, and applicable to services provided on or after March 1, 2020. Flexibility for Medicaid Laboratory Services ....... We are revising § 440.30 to provide states with flexibility to provide Medicaid coverage for cer- tain laboratory tests and X-ray services that may not meet certain requirements in § 440.30(a) or (b) (such as the requirement that tests be furnished in an office or similar fa- cility). This flexibility is retroactive to March 1, 2020, during the period of the COVID–19 PHE and for any subsequent periods of active surveillance. The flexibility also applies to fu- ture PHEs resulting from outbreaks of communicable disease and subsequent periods of ac- tive surveillance. Requirement for Facilities to Report Nursing We are revising § 483.80 to establish explicit reporting requirements for long-term care (LTC) Home Residents and Staff Infections, Poten- facilities to report information related to COVID–19 cases among facility residents and staff. tial Infections, and Deaths Related to These reporting requirements are applicable on the effective date of this IFC. COVID–19. Separate Billing and Segregation of Funds for We are delaying by 60 days the date when individual market qualified health plan (QHP) Abortion Services. issuers must be in compliance with the separate